Patient Preference and Perception of Care Provided by Advance Nurse Practitioners and Physicians in Outpatient Adult Congenital Clinics

Congenit Heart Dis. 2015 Sep-Oct;10(5):E225-9. doi: 10.1111/chd.12273. Epub 2015 May 23.


Objective: Nurse practitioners (NPs) have an established role for delivering competent care to patients in the primary care setting. The aim of this study was to compare satisfaction of patients managed by NPs vs. physicians in the outpatient adult congenital heart disease (CHD) clinic.

Design: A prospective study conducted in two outpatient adult CHD clinics to assess patient satisfaction through standardized surveys. Demographic data included CHD diagnosis, age, and New York Heart Association functional class. All patients completed a Short-Form-12 to assess health status.

Results: Of the 371 patients recruited (52% men; median age 29 years, severe CHD complexity 31.5%) and seen by NP (n = 187) or physician (n = 184), physician-managed practices had higher perceived: overall experience, courtesy of provider (P < 0.05) and confidence (trust) in provider (P < 0.1). Overall, patients reported satisfaction with an NP providing care (98%), the NP was able to effectively deal with illness/CHD (95%), and an increased chance (94%) or willingness to see an NP at a future visit. Only 73% reported an understanding of NP training and how an NP differed from a registered nurse. There was a stronger perception of how an NP differed from a physician (83%).

Conclusion: Patient satisfaction was high regardless of whether care was provided by physicians or NPs. However, patients appear to make distinctions in what they believe the type of care each practitioner is best at providing. Patient education regarding competence of the different health care providers may continue to improve patient satisfaction.

Keywords: Adult; Congenital Heart Disease; Nurse Practitioner; Patient Satisfaction; Quality Care; Treatment Outcomes.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Advanced Practice Nursing*
  • Attitude of Health Personnel
  • Clinical Competence
  • Cross-Sectional Studies
  • Delivery of Health Care
  • Female
  • Health Care Surveys
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Nurse Practitioners*
  • Ohio
  • Outpatient Clinics, Hospital*
  • Patient Education as Topic
  • Patient Preference*
  • Pennsylvania
  • Perception*
  • Physician-Nurse Relations
  • Physician-Patient Relations
  • Physicians*
  • Prospective Studies
  • Surveys and Questionnaires
  • Young Adult